A Contagion of Folly
In 2000, the Centers for Disease Control made a happy announcement: Measles, a disease that sent tens of thousands of Americans to hospitals every year and was responsible for 400-500 annual deaths—mostly of those under the age of 10—had been eradicated.
But the disease is back. There have been so many cases in Washington state that Gov. Jay Inslee has declared a state of emergency. Outbreaks have also been seen in 20 other states. What happened? Did the virus get smart? Did it mutate in response to our carefully targeted vaccines? No, we got dumb.
The Pacific Northwest is renowned for its natural beauty. It is also home to some of the most successful “anti-vaxxer” activists in the country. In Clark County up to 25 percent of children are unvaccinated. The parents who opt out of vaccinating their children are being led astray by a grab bag of conspiracists, frauds, and quacks who peddle disinformation about vaccines on the internet.
Ethan Lindenberger, a high school student from Ohio, testified on March 5 before the Senate Committee on Health, Education, Labor, and Pensions that his mother was among those who had been misled into distrusting vaccines. Neither he nor his younger siblings was vaccinated against preventable diseases, including polio. When he reached his 18th birthday, Lindenberger went ahead and got himself vaccinated. Though he tried valiantly to persuade his mother that she was relying on junk science, and attempted to prove his case by pointing out studies posted on the website of the CDC, she was unmoved. “That’s what they want you to think,” she protested. Where did she get her information? Facebook.
Lindenberger’s mother speaks for thousands who have swallowed the idea that the drug companies are in a conspiracy with the government to push vaccines on children despite the “fact” that vaccines cause autism and other diseases. Never mind that the link to autism has long since been debunked as a myth. The originator of the claim, Andrew Wakefield, who published a 1998 paper alleging a link in the Lancet, was found to be a fraud and lost his medical license in Great Britain. The Lancet repudiated the paper. But the vaccines-cause-autism bunk was off and running, and truth is having trouble catching up. Today, the Pacific Northwest, California, and Texas now feature significant communities that reject the MMR (measles, mumps, rubella) and other vaccines.
Most of the senators at the hearing had their heads screwed on straight. They praised young Lindenberger’s judgment and emphasized the danger of misinformation about life-saving vaccines. But there was one exception—Sen. Rand Paul of Kentucky. While acknowledging that he and his family are vaccinated and that the benefits outweigh the risks, Paul proclaimed, to the applause of the anti-vaxxers in the audience, that he opposed any government effort to require vaccination. “I still do not favor giving up on liberty for a false sense of security.”
False? The falsity came entirely from Senator Paul, who is not new to anti-vax signaling. In 2015, he told Laura Ingraham’s radio audience that he had heard “heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines.” That is precisely the kind of anecdote that crowds the anti-vax messages on Facebook and other social media. But the plural of anecdote is not data, as Dr. Paul, presumably a man of science, should know. Nor is it true, as Paul suggested, that the unreliability of the flu vaccine is similar to the MMR. The seasonal flu vaccine is based upon the best guess about which strain will predominate in the coming year. Sometimes the guesses are wrong, and the vaccine is less helpful in some years than others. But the MMR, if administered to more than 95 percent of the population, absolutely provides protection from serious diseases.
At the very least, measles causes a bout of illness that keeps children out of school for more than a week and causes parents to take time off from work. About 10 percent of cases also result in ear infections, which can cause permanent hearing loss. One in 20 cases of measles results in pneumonia, the most common cause of measles deaths among young children. And in one out of 1,000 cases, the child will get encephalitis, leading to convulsions that can cause deafness or intellectual disability. For every 1,000 measles cases, one or two deaths are expected. Pregnant women who contract rubella often have children with birth defects.
Anti-vax fervor is not limited to the left or right. In fact, the common denominators seem to be wealth and education. Robert Kennedy Jr. is a prominent advocate, and Donald Trump dabbled in anti-vax fear-mongering. In 2012, Trump tweeted, “Massive combined inoculations to small children is the cause for big increase in autism.” Fact check, false. Kennedy was spotted at Trump tower during the transition, and there were rumors of a presidential commission to look into the purported link to autism, but Trump evidently thought better of it.
Decades of research have found no link between MMR and autism, and a recent study from Denmark that followed more than 600,000 children provides yet more solid evidence that the link is non-existent. As the New York Times reported:
In emphatic language, the researchers, who followed 657,461 Danish children born between 1999 and 2010, stated in the Annals of Internal Medicine: “The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination.”
On the contrary, the study found that children who were unvaccinated were 7 percent more likely to become autistic than those who got the vaccine.
Some libertarians, like Rand Paul, frame this issue as one of liberty. The groups’ names reflect this orientation: American Citizens for Health Choice (ACHC), National Health Freedom Coalition, Michigan for Vaccine Choice, Texans for Vaccine Freedom, and A Voice for Choice. But their claims don’t meet even the standard for libertarian consistency. Libertarians generally favor the maximum amount of personal liberty consistent with social peace. But you cannot endanger others in the name of liberty, and some libertarians, like Reason’s Ronald Bailey, cite Oliver Wendell Holmes’ argument that.“The right to swing my fist ends where the other man’s nose begins.”
Anti-vax parents are not just endangering their own kids (though a court might be convinced that even that stretches a parent’s authority too far), they are compromising the most vulnerable members of the community. Herd immunity” requires vaccination rates of about 95 percent; otherwise those with compromised immune systems are at high risk. Kids who are sick with cancer or other diseases that preclude vaccination can become infected. Measles is so contagious that if one person in a family gets measles, the chances are 90 percent that others will become infected if they are unvaccinated. A sneeze in an elevator can leave live virus in the air for two hours. That swing of “I’m not vaccinating my children,” may wind up hitting the nose of a child with cystic fibrosis.
The flowering of conspiracy theories, unscientific hooey, and dangerous lies is a feature of the era we are pleased to call the information age. Edmund Burke warned that “Example is the school of mankind, they will learn at no other.” Who would have guessed that even in a matter such as vaccinating children—one of the greatest gifts of the modern age—we would have to relearn the obvious?
As David Oshinksy recounts in Polio: An American Story, the news that the Salk vaccine was successful set off a huge public celebration. On April 12, 1955, “Church bells rang, factory whistles blew. People ran into the streets weeping. President Eisenhower invited Jonas Salk to the White House, where he choked up while thanking Salk for saving the world’s children — an iconic moment, the height of America’s faith in research and science. Vaccines became a natural part of pediatric care.”
The only thing worse than contagion of germs is contagion of folly.